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Second wave deadlier than first wave for pregnant women: ICMR-NIRRH study

The study, funded by the Indian Council of Medical Research–National Institute for Research in Reproductive Health, Mumbai, reported higher pregnancy complications and maternal deaths during the second wave as compared to the first wave of the pandemic.

Written by Anuradha Mascarenhas | Pune |
July 8, 2021 11:45:58 pm
Pregnant women get tested for Covid-19 in Mumbai. (Express Photo by Amit Chakravarty)

More number of pregnant women with severe Covid-19 infection requiring ICU admissions were admitted during the second wave as compared to first wave, according to a new study, ‘Pregnancy Outcomes and Maternal Complications during the Second Wave of Covid-19 in India’, published in the Journal of American College of Obstetricians and Gynecologists (ACOG).

The study, funded by the Indian Council of Medical Research–National Institute for Research in Reproductive Health, Mumbai, reported higher pregnancy complications and maternal deaths during the second wave as compared to the first wave of the pandemic.

Most of the deaths were a result of Covid-19 pneumonia and respiratory failure, the study found. The findings suggest the importance of offering vaccination to pregnant and lactating women during the ongoing pandemic, researchers said.

India’s Ministry of Health and Family Welfare recently issued guidelines on vaccination of pregnant women against Covid-19.

To assess the impact of the second wave on pregnant women, PregCovid registry investigators conducted a cohort study and analysed the data of 1,530 pregnant and postpartum women admitted during the first and second waves of the Covid-19 pandemic at BYL Nair Charitable Hospital in Mumbai.

A total of 1,530 pregnant and postpartum women were admitted as per the admission policy during the first (1,143) and second waves (387) of the pandemic. Of the 1,143 women in the first wave from April 1, 2020 to January 31, 2021, eight died, while 22 of the 387 women admitted during the second wave (Feb 1-May 14 2021) died.

Dr Smita Mahale, former director, ICMR-NIRRH, Dr Niraj Mahajan, BYL Nair Charitable hospital and Dr Rahul Gajbhiye, ICMR-NIRRH, conducted the study. Researchers said it was likely that the most virulent variant of concern, B.1.617, was responsible for these higher complications and deaths.

“We calculated the maternity mortality ratio per 1,000 births and there was an almost eight fold rise in the second wave,” Dr Gajbhiye told The Indian Express. From 10.2/1000 births, the MMR rose to 83.3/1000 births in the second wave, he said.

The rates of severe Covid-19, admission to the intensive care unit or high dependency unit case fatality rate and maternal mortality ratio were higher during the second wave. For instance, there were 27 women who were admitted to the ICU/HDU in the first wave while 45 women required intensive care in the second wave. In the first wave, there were 19 women with severe Covid-19 while in the second wave, there were 33 severe cases.

While data are limited to a single centre, researchers said it was possible that higher case rates and delays in seeking healthcare contributed to increased mortality during the second wave.

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